Liver

Question 1

Describe hemangioma on imaging

Answer 1

peripheral nodular enhancement in arterial phase, centripedal enhancement with persistent enhancement in delayed phase

Question 2

Describe adenoma on imaging

Answer 2

Early arterial enhancement, loss of enhancement in delayed phase

Question 3

Describe focal nodular hyperplasia on imaging

Answer 3

iso/hypoattenuated on noncontrast, arterial enhancement, loss of enhancement in delayed phase, central scar retains enhancement during venous phase
Also + with sulfur colloid scan

Question 4

What’s size criteria for resection hemangioma

Answer 4

> 5 cm

Question 5

What’s the estimated future liver remnant needed for hepatectomy?

Answer 5

without cirrhosis: 20-25%
Child Pugh A: >40%
Child Pugh B/C: generally don’t tolerated resection

Question 6

What’s Milan criteria

Answer 6

HCC candidacy for transplant:
- Single tumor <5 cm or <=3 tumor total each <3 cm
- No angioinvasion
- No extrahepatic involvement

Question 7

What threatment for unresectable HCC?

Answer 7

Bevacizumab with atezolizumab. (Used to be sorafenib)

Question 8

What’s most common cause of Budd Chiari?

Answer 8

Myeloproliferative disorder, OCP 2nd, FVLD 3rd, idiopathic 4th,

Question 9

What’s the order of vascular ligation for hepatectomy?

Answer 9

Hepatic artery, then portal vein, then hepatic vein

Question 10

When is thrombolytic therapy an option for Budd Chiari?

Answer 10

3-4 weeks from onset

Question 11

What does amebic abscess look like on imaging? What’s treatment?

Answer 11

target/double ring sign, thickened wall
Flagyl, drain if persistent, excise wall if ruptured

Question 12

What does hydatid cyst look like on imaging? What’s treatment?

Answer 12

Calcified ectocyst with endocysts
Albendazole followed by excision